Coumarin Necrosis
Authors: JAN KOCH-WESER
Journal: Annals of Internal Medicine (1968)

Editorial Notes1 June 1968Coumarin NecrosisJAN KOCH-WESER, M.D.JAN KOCH-WESER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-6-1365 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe only frequent adverse reaction during therapy with oral anticoagulants is bleeding due to depression of vitamin K-dependent hepatic clotting proteins. Untoward effects not related to the desired pharmacologic action of coumarin derivatives are unusual and generally benign events such as gastrointestinal dysfunction, hypersensitivity dermatitides, drug fever, and alopecia. Only one serious complication remains poorly understood: coumarin necrosis of skin and subcutaneous tissue. Widely reported in Europe (1-10) it has received little attention in English-speaking countries (11-14) and is still being misinterpreted as a hemorrhagic effect.Although clinical use of bishydroxycoumarin began in 1940, coumarin necrosis was not recognized until...References1. VERHAGEN H: Local haemorrhage and necrosis of the skin and underlying tissues, during anti-coagulant therapy with Dicumarol or Dicumacyl. Acta Med. Scand. 148: 453, 1954. CrossrefMedlineGoogle Scholar2. JORDAL R: Necrosing cutaneous haemorrhages as a complication in Dicumarol treatment. Acta Med. Scand. 154: 477, 1956. CrossrefMedlineGoogle Scholar3. MIKKELSEN PM: Abortiv hemorrhagisk hudnekrose efter Dicumarol. Nord. Med. 60: 1758, 1958. MedlineGoogle Scholar4. FRIES K: Hautinfarkte bei der Thromboembolie-Prophylaxe. Gynaecologia 148: 47, 1959. MedlineGoogle Scholar5. STEFENELLI N, TULZER H, and WEWALKA F: Hautnekrosen als Nebenwirkung der Therapie mit Antikoagulantien. Thrombos. Diath. Haemorrh. 5: 136, 1960. 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Amer. J. Pathol. 20: 651, 1944. MedlineGoogle Scholar19. NEUMAYR A and SCHMID J: Kapillarpermeabilität und Antithrombon. Schweiz. Med. Wschr. 78: 616, 1948. MedlineGoogle Scholar20. MATIS P and HAGER H: Zur Wirkung des Dicumarols auf die Permeabilität der Capillaren. Z. Ges. Exp. Med. 118: 131, 1951. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAN KOCH-WESER, M.D.Affiliations: Departments of Pharmacology and Medicine Harvard Medical School Massachusetts General Hospital Boston, Mass. 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A rare complication of warfarin therapyDrug Effects in Geriatric PatientsChronic Ulcerative Colitis, Skin Necrosis, and CryofibrinogenemiaGENE V. BALL, M.D., F.A.C.P., LAWRENCE N. GOLDMAN, M.D.Warfarin-Induced Necrosis of SkinJEROME P. LACY, M.D., ROBERT R. GOODIN, M.D., F.A.C.C.Infarction of the mammary recion mimicking carcinoma of the breastAnticoagulantsDisseminated intravascular coagulationCOUMARIN NECROSISCoumarin-induced skin necrosis in a sixteen year old girlA CASE OF COUMARIN‐INDUCED SKIN NECROSISMore Notes on Recent ANNALS ThemesE. J. H. 1 June 1968Volume 68, Issue 6Page: 1365-1367KeywordsAdverse reactionsAnticoagulant therapyAnticoagulantsCoumarinsDrugsFeversHemorrhageHypersensitivityNecrosisProteins ePublished: 1 December 2008 Issue Published: 1 June 1968 PDF downloadLoading ...